Manifestation of pain syndrome in lumbar instability

Authors

  • A.N. Vitkovskiy SI “Institute of Traumatology and Orthopedics of the NAMS of Ukraine”, Kyiv, Ukraine,
  • I.V. Fishchenko SI “Institute of Traumatology and Orthopedics of the NAMS of Ukraine”, Kyiv, Ukraine,

DOI:

https://doi.org/10.22141/1608-1706.4.21.2020.212534

Keywords:

functional motion unit, instability, pain syndrome, neurological disorders

Abstract

Background. The article deals with the data on the results of the study and treatment of 57 patients with pain syndrome in lumbar instability. Patients received the inpatient treatment in the Spine Surgery Department of SI “Institute of Orthopedics of the NAMS of Ukraine”, Kyiv, from 2016 to 2018. Materials and methods. The study is based on an analysis of the results of the study and treatment of 57 patients with pain syndrome in lumbar instability. The study analyzed the patients’ medical histories, examination, observational radiography of spine in functional position, functional radiography of spine. Results. Patients were selected according to the following criteria: the presence of vertebrogenous pain and neurological syndrome, which manifested itself in sensory and motor impairments due to instability in the lumbar functional spinal unit. The discogenic instability (13 (22. 8 %) patients) is associated with intense pain at the level of lumbar functional spine unit, back muscle tension, physical inactivation at the level of damaged segments and adherent segments. The sympathetic syndrome, intensive pain in the functional unit, the tension in back muscles, restrictions of motions at the level of damaged and adherent segments are common in the discogenic instability (19 (33.3 %) patients). In disk arthrosis associated instability, the patients (29 (50.9 %)) developed a radicular syndrome, a moderate local pain (lumbago, lumbodynia), which increases with movement, changes of torso positions, restriction of motions, morning stiffness, decreased muscular strength in lower extremities, dysfunction of the pelvic organs. The disk arthritis osteogenic instability (9 (15.8 %) patients) was associated with clinical local pain, impaired motor function of a segment, the tendency to dislocation of the vertebra, or damage of spine components with symptoms of stenosis of spinal canal, radicular and vascular abnormalities, spinal deformity. Conclusions. Types of the instability of the lumbar motor segment are relative with the specificity of structural changes in the intervertebral discs, facet joints, and the interarticular part of the vertebra. Neurological manifestations depend on localization and degree of instability in the lumbar spine. Among the pain syndromes, nerve root pains (29 patients (50.9 %)) and lumbago (19 patients (33.3 %)) prevail. Spinal instability is followed by reflex syndromes. Reflex syndromes include lumbago in case of the acute or chronic progression of an illness, lumbodynia in case of subacute and chronicity. Radiculopathy is the most common disease among nerve root syndromes, radiculopathy occurred in 9 (15.8 %) patients.

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Published

2020-08-01

Issue

Section

Original Researches